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Find Out What's Causing Your Heartburn

February 26, 2012

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There are many terms for acid reflux, such as heartburn, indigestion, GERD, dyspepsia, but whatever you call it; it’s a condition that can occur throughout your life. Approximately 20% of Americans experience symptoms of heartburn at least one time a week. Acid reflux occurs when the stomach contents leaks back into the esophagus causing irritation in the esophagus and symptoms of heartburn, nausea, regurgitation, coughing, wheezing, difficulty swallowing, hiccups, sore throat and hoarseness. There are several causes of acid reflux and its best to determine what the cause is so you can fix it before stomach acid can damage the esophagus.

 

Lower Esophageal Sphincter (LES) Problems

The lower esophageal sphincter is the muscle ring at the end of the esophagus where it meets the stomach. When you eat or drink the sphincter opens to allow the food to pass and then closes again. However, when you have acid reflux there is a problem with the LES because it allows the contents of your stomach to flow back up into your esophagus. Abnormalities with the LES can cause a weak contraction when the sphincter closes. This causes the LES to be too relaxed making it easier for reflux to occur.

 

Hiatal Hernia

A hiatal hernia is a condition where the stomach sticks upward into the chest through an opening in the diaphragm. This is a problem because it disrupts the location of the LES pushing it up into the chest and it is no longer level with the diaphragm. When the LES and diaphragm are level they work as a strong unit putting double the pressure on the sphincter to prevent acid reflux. When the LES is higher than the diaphragm there is less pressure when the LES closes. The contents of the stomach push back up on the LES and the tissue can become warped. Overtime the LES is useless to stop reflux.  In some cases hiatal hernias are caused by hernia sacs. The sac is close to the esophagus and acid gets trapped inside the sac. Once the LES relaxes the acid backs up into the esophagus causing heartburn. Hiatal hernias do not occur in all cases of acid reflux and can occur at any age.

 

Smoking

After swallowing the esophageal muscles contract to push all the items in the esophagus down into the stomach.  Smoking disrupts the clearing of the esophagus leaving acid within. Cigarette smoking reduces the function of the LES, impairing its ability to contract and close the sphincter. Smoking is a bad habit, which is a detriment to ones health. It damages mucus membranes, increases acid secretion and reduces salivation.  All of which are contributing factors to acid reflux.

 

Food

Acid reflux is most common after eating, especially if you eat large meals or snack before you go to bed. Lying down right after eating worsens acid reflux. Gravity pushes food and acid down into the stomach, however when you lay down the contents of your stomach can easy flow back up into the esophagus causing heartburn and indigestion. When you eat large meals it puts pressure on the stomach causing the contents of your stomach to be forced out and up into the esophagus. By eating smaller meals and allowing them to digest for two hours you can avoid acid reflux. Some foods trigger acid reflux such as alcohol, carbonated beverages, chocolate, citrus fruits, coffee, tea, fatty foods, fried foods, tomatoes, garlic, onions, mint, and spicy foods.  Its best to eliminate these foods from your diet as much as possible to avoid causing acid reflux.

 

Pregnancy

Many women experience acid reflux for the first time during pregnancy. This is due to a couple of reasons. First the levels of hormones are increased during pregnancy. Elevated progestin causes the pressure on the LES to decrease, making it easier to acid to flow back up into the esophagus. Second pressure from the growing fetus on the stomach and other internal organs causes stomach contents to rise into the esophagus. Acid reflux symptoms usually are worst during the third trimester. Symptoms almost always go away once the baby is born.

 

Obesity

Being overweight is a lifestyle issue, however it affects the symptoms of acid reflux. Excess weight increases the pressure in the stomach, pushing the contents up into the esophagus. That is why 35% of overweight people experience heartburn symptoms. Losing weight is a personal choice, however it will not only give you health benefits, but by decreasing your weight by only 10% it will reduce your heartburn symptoms dramatically.

 

Medications

Medications both over the counter and prescription can trigger symptoms of acid reflux. It’s always best to check with your doctor and read the label before starting a medication to determine if the side effects can cause acid reflux. Over the counter medications include aspirin, and ibuprofen. Prescription medications that worsen acid reflux include muscle relaxers, anticholinergic (seasickness), beta-blockers for high blood pressure and heart disease, bronchodilators for asthma, calcium channel blockers for high blood pressure, dopamine-active drugs for Parkinson’s, progestin, sedatives for insomnia, tricyclic antidepressants, and bisphosphonates which treat osteoporosis in women.